1013407634 NPI number — LAPRISE COUNSELING SERVICES PLLC

Table of content: (NPI 1013407634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013407634 NPI number — LAPRISE COUNSELING SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAPRISE COUNSELING SERVICES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013407634
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 TOWNE HOUSE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMDEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06514-2103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 GIFFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTPORT
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02790-3414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
774-930-6515
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2018

Additional Information

Authorized Official

Authorized Official Last Name:
LAPRISE
Authorized Official First Name:
JUSTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
774-930-6515

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008078345 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com